Psychotherapy: SAS/Review
This flashcard set covers important clinical insights related to pharmacology, defense mechanisms, neurodegenerative disorders, and long-term medication side effects. Topics include serotonin-related risks with opioids like tramadol and fentanyl, the use of sublimation as a defense mechanism, early cognitive decline in Lewy Body Dementia, and the emergence of tardive dyskinesia after prolonged use of first-generation antipsychotics.
Which opioids affect serotonin levels?
Why is this important?
Tramadol, fentanyl
Patients on serotoninergic agents should not take!
Can lead to serotonin syndrome (altered mental status, autonomic dysfunction, neuromuscular abnormalities)
Key Terms
Which opioids affect serotonin levels?
Why is this important?
Tramadol, fentanyl
Patients on serotoninergic agents should not take!
Can lead to ser...
What kind of defense mechanism:
A perosn is angry at their phsysician for cancelling their appointment. They end up cleaning their entire department to avoid thinking about being angry
Sublimation
Channeling anger, discomfort, unpleasant thoughts at productive activities
Which cognitive domain will be affected first in Dementia with Lewy Bodies?
Attention/executive function, visuospatial reasoning
Will also have Parkinsonism
(Par...
Which side effect of first-generation antipsychotics is likely to present after decades of use?
Tardive dyskinesia
Due to long term dopamine blockade
chlorpromazine, fluphen...
Describe the general timeline of symptoms onset during alcohol withdrawal
6-48h: ANS hyperactivity
12-48h: Seizures
12-24h: Hallucinations
3-5+ days: Delirium Tremens
Which cognitive domain will be affected first in Frontotemporal Dementia?
Personality changes, language deficits
(Frontal lobe)
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| Term | Definition |
|---|---|
Which opioids affect serotonin levels? Why is this important? | Tramadol, fentanyl Patients on serotoninergic agents should not take! Can lead to serotonin syndrome (altered mental status, autonomic dysfunction, neuromuscular abnormalities) |
What kind of defense mechanism: A perosn is angry at their phsysician for cancelling their appointment. They end up cleaning their entire department to avoid thinking about being angry | Sublimation Channeling anger, discomfort, unpleasant thoughts at productive activities |
Which cognitive domain will be affected first in Dementia with Lewy Bodies? | Attention/executive function, visuospatial reasoning Will also have Parkinsonism (Parietal lobe) |
Which side effect of first-generation antipsychotics is likely to present after decades of use? | Tardive dyskinesia Due to long term dopamine blockade chlorpromazine, fluphenazine, thioridazine, haloperidol |
Describe the general timeline of symptoms onset during alcohol withdrawal |
|
Which cognitive domain will be affected first in Frontotemporal Dementia? | Personality changes, language deficits (Frontal lobe) |
What are the risks associated with MAO inhibitors? |
MAOi Hydrazine Tranylcypromine Rasagiline |
Which drugs increase serum Lithium levels? |
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What factors might precipitate delerium? | I-WATCH-DEATH The slides specifically highlight factors in bold
|
What is the difference between schizoaffective disorder and schizophrenia? |
(Thank you @Nathan Shlobin!) |
Which area/circuit of the brain is impaired in Alzheimer’s Disease? | Limbic Network |
Abnormal eye movements (nystagmus) are characteristic of which drug intoxication? | Phencyclidine (PCP) |
Which antidepressants are contraindicated in patinets with current or history of anorexia nervosa or bulimia nervosa? | Bupropion |
Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? Serotonin | Wakefullness Raphe nuclei (pons) |
Which antipsychotics are most likely to have side effects of involuntary facial movements, restlessness, and dystonia? | High-potency first-generation antipsychotics
|
Hoover’s sign provides evidence for which disorder? | Functional Neurological Disorder (aka conversion disorder) |
Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? Orexin | Wakefulness Lateral hypothalamus |
Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? Histamine | Wakefulness Tuberomamillary nucleus (hypothalamus) |
What differentiates Bipolar I from Bipolar II? |
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Rapid withdrawal of what hormone can trigger migraine? | Estrogen
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What is the most consistent but non-specific neuroimaging finding in schizophrenia? | Enlarged ventricles
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Which seizure medications are prefered in women of childbearing age? | Lamotrigine, levetiracetam Sometimes carbamazepine Avoid valproate, topiramate!! |
What is the most effective treatment for insomnia? | Cognitive behavioral therapy Focuses on:
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What is the difference between schizotypal and schizoid personality disorders? |
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Which area/circuit of the brain is impaired in semantic aphasia/dementia? | Central pathway of vision (temporal lobe) |
A set of sidely scattered but orchestrated crerebral areas that are activated by a specific task observed on neuroimaging is a…
| c. Channel network |
Schizophrenia is a [developmental/degenerative] disorder What is the brain pathology? | Schizophrenia is a developmental disorder Results from abnormal neuronal migration during development |
What are the classic features of MDD, melancholic subtype? |
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Which antipsychotic may cause neutropenia? | Clozapine
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What kind of seizure is associated wtih tongue biting? | Generalized tonic/clonic seizure |
What time period constitutes persistent depressive disorder? | 2+ years of depressed mood for most of the day, more days than not |
Which area/circuit of the brain is impaired in Lewy Body Dementia? | Dorsal Pathway of Vision (parietal lobe) |
What syndrome is associated with thamine deficiency? Which population is at particular risk? | Wernicke-Korsakoff Syndrome People with alcohol-use disorder
|
Automatisms and aura of a funny taste in one's mouth before a seizure are characteristic of which kind of epilepsy? | Temporal lobe epilepsy Automatism = fumbling with clothing/button, cannot stop |
Which type of reinforcement schedule has the fastest extinction? Which types have the slowest extinction? | Fastest extinction = continuous (also has fastest learning) Slowest extinction = variable interval or variable ratio (Fixed interval and fixed ratio have the fastest conditioning) |
Which antipsychotics are likely to cause abnormal lactation? |
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List the parts of the Papez circuit, in order |
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What kind of medication is cyclobenzaprine? | Muscle relaxant |
Which sleep disorder is associated with low orexin levels in the CSF? Describe 3 associated symptoms | Narcolepsy
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Which area/circuit of the brain is impaired in frontal type dementia? | Frontal cortex |
What kind of defense mechanism: A perosn is angry at their psysician for cancelling their appointment. Next time they see their physician, they compliment the physician on their shirt | Reaction formation | (Doing the opposite of what you feel) |
Which class of antidepressants is most likely to have cardiac effects? What are the effects? | TCAs Long QT -> Torsades (potentially fatal arrhythmia)
|
How is lithium metabolized? | Excreted unchanged by the kidney (No hepatic metabolism) |
Which cognitive domain will be affected first in Alzheimer's Disease? | Memory | (Limbic system) |
What are the indications for haloperidol in a patient with delerium? |
But remember, the focus of the treatment should always be the underlying cause!! |
What further testing is indicated when a child presents with signs and symptoms of autism spectrum disorder? |
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How are abscence seizures differentiated from focal seiziures without loss of consciousness? | No post-ictal period (confusion) after abscence seizure |
According to Robins and Guze (1970), what 5 steps can help achieve diagnostic validity for psychiatric disorders? |
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Which kind of reinforcement schedule results in the fastest conditioning? | Fixed schedules - type of partial reinforcement (Continuous reinforcement has the fastest learning) |
What are the classic features of MDD, atypical subtype? |
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Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? Norepinephrine | Wakefulness Locus ceruleus (pons) |
Which medication can be used to augment the effects of SSRIs and is known for reducing the risk of suicide? | Lithium |
Is this neurotransmitter associated with wakefullness or sleep? Where is it secreted? GABA | Sleep Ventrolateral peroptic nucleus (VLPO) |
What is a "homeopathic" treatment? | Like treating like Ex: using seizures in ECT to help treat patients with seizures |